不稳定型胸腰椎骨折患者行经伤椎椎弓根螺钉固定的效果研究

Effect of Pedicle Screw Fixation in Patients with Unstable Thoracolumbar Fracture

目的探讨不稳定型胸腰椎骨折(unstable thoracolumbar fracture,UTF)患者行经伤椎椎弓根螺钉固定的应用效果。方法方便选取2020年3月—2021年2月期间菏泽市第六人民医院收治的不稳定型胸腰椎骨折患者94例为研究对象,参照随机数表法对其进行分组,每组47例。对照组行跨伤椎椎弓根螺钉固定治疗,研究组行经伤椎椎弓根螺钉固定治疗。比较两组患者临床疗效,术前、术后6个月的椎体压缩率、后凸Cobb角、椎体前缘高度,以及疼痛情况与腰椎功能,术后并发症情况。结果研究组总有效率为95.74%,较对照组的80.85%高,差异有统计学意义(χ^(2)=5.045,P<0.05)。术后6个月,研究组椎体前缘高度较对照组高,伤椎后凸Cobb角、伤椎体压缩率较对照组低,差异有统计学意义(P<0.05)。研究组ODI评分较对照组低,差异有统计学意义(P<0.001)。两组VAS评分对比,差异无统计学意义(P>0.05)。两组术后并发症发生率均为2.13%,差异无统计学意义(P>0.05)。结论UTF患者应用经伤椎椎弓根螺钉固定能够有效促进椎体恢复。

Objective To investigate the effect of pedicle screw fixation on unstable thoracolumbar fracture(UTF).Methods It was conveniently to select 94 patients with unstable thoracolumbar fracture treated in Heze Sixth People's Hospital from March 2020 to February 2021 as the research objects.They were grouped according to the random num⁃ber table,with 47 cases in each group.The control group received pedicle screw fixation across injured vertebrae,and the study group received pedicle screw fixation through injured vertebra.Clinical efficacy,vertebral compression ratio,kyphotic Cobb angle,anterior vertebral border height,pain,lumbar function,and postoperative complications were compared between the two groups.Results The total effective rate of 95.74%in the study group was higher than 80.85%in the control group,the difference was statistically significant(χ^(2)=5.045,P<0.05).Six months after surgery,the vertebral anterior margin height of the study group was higher than that of the control group,and the Cobb angle and compression ratio of the injured vertebral body were lower than that of the control group,the difference was statis⁃tically significant(P<0.05).The ODI score of the study group was lower than that of the control group,the difference was statistically significant(P<0.001).There was no statistically significant difference in VAS score between the two groups(P>0.05).The incidence of postoperative complications was 2.13%in both groups,and there was no statisti⁃cally significant difference between the two groups(P>0.05).Conclusion Pedicle screw fixation can effectively pro⁃mote vertebral recovery in patients with UTF.